摘要
目的分析高危妊娠孕产妇发生早期肾损伤的危险因素,为临床预防提供依据。方法选择2018年1月至2019年1月浙江普陀医院收治的213例高危妊娠孕产妇为研究对象。根据是否出现肾损伤分为研究组(n=98)和对照组(n=115),研究组为高危妊娠合并肾损伤者,对照组为高危妊娠者。观察两组患者临床资料、生化指标及肾功能指标的差异,同时利用多因素Logistic回归分析影响高危妊娠孕产妇发生肾损伤的危险因素。结果213例高危妊娠孕产妇中,出现98例肾损伤(46.01%)。经比较,研究组血小板、血浆纤维蛋白原、白蛋白、pH值低于对照组(t值分别为5.069、3.698、19.571、7.874,均P<0.05),而研究组白细胞计数、血浆凝血酶原时间、血钾、血清肌酐、尿酸、血清胱抑素水平显著高于对照组(t值分别为2.970、4.834、4.669、11.474、8.632、15.931,均P<0.05)。多因素Logistic回归分析显示,舒张压、收缩压、尿蛋白、白细胞计数、肌酐、尿酸、血清胱抑素水平均是影响高危妊娠孕产妇发生早期肾损伤的独立危险因素(β值分别为-0.070、0.549、-0.637、1.579、0.320、0.191、-0.219,均P<0.05)。结论高危妊娠继发肾损伤的发病率较高,且舒张压、收缩压、尿蛋白、血清肌酐、尿酸、血清胱抑素是影响早期肾损伤发生的独立危险因素,故应密切监测高危妊娠妇女的身体状况并早期采取有效的预防干预措施,从而降低妊娠期肾损伤的发生风险。
Objective To investigate the high risk factors and related intervention measures for early renal injury in high-risk pregnant women.Methods 213high-risk pregnant women admitted to Zhejiang Putuo Hospital from January 2018to January 2019were selected and divided into study group(high-risk pregnant women with renal injury,n=98)and control group(high-risk pregnant women without renal injury,n=115)according to presence or absence of renal injury.The differences of clinical data,biochemical indicators and renal function indicators between the two groups were compared,and multivariate Logistic regression analysis was used to determine the high risk factors of renal injury in high-risk pregnant women.Results Among 213high-risk pregnant women,98(46.01%)cases had renal injury.After comparison,the levels of platelet,fibrinogen(Fib),albumin and pH value in the study group were significantly lower than those in the control group(t=5.069,3.698,19.571and 7.874,respectively,all P<0.05),and the count of white blood cell,the levels of prothrombin time(PT),potassium in blood,creatinine(Cr),uric acid(UA)and serum cystatin in the study group were significantly higher than those in the control group(t=2.970,4.834,4.669,11.474,8.632and 15.931,respectively,all P<0.05).Diastolic blood pressure,systolic blood pressure,urinary protein,the count of white blood cell,the levels of Cr,UA and serum cystatin were independent risk factors for renal injury in high-risk pregnant women(β=-0.070,0.549,-0.637、1.579、0.320、0.191and-0.219,respectively,all P<0.05).Conclusion The incidence of renal injury in high-risk pregnancy is high,and diastolic blood pressure,systolic blood pressure,the levels of urinary protein,Cr,UA,and serum cystatin are independent risk factors that affect renal injury during pregnancy.Therefore,high-risk pregnant women should be closely monitored and taken early effective interventions to reduce the risk of renal injury during pregnancy.
作者
缪晟
陈宁
周攀
MOU Sheng;CHEN Ning;ZHOU Pan(Department of Kidney Medicine,Zhejiang Putuo Hospital,Zhejiang Zhoushan 316100,China)
出处
《中国妇幼健康研究》
2020年第3期368-371,共4页
Chinese Journal of Woman and Child Health Research
关键词
高危妊娠
肾损伤
高危因素
干预措施
high-risk pregnancy
renal injury
high risk factors
intervention
